Maternal sleep behaviours preceding fetal heart rate events on cardiotocography

Wilson, Danielle L; Fung, Alison; Skrzypek, Hannah; Pell, Gaby S.; Barnes, Maree; Walker, Susan

doi:10.1113/jp282528

Cited by 6 publications

(2 citation statements)

References 66 publications

(120 reference statements)

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“…Whilst the healthy placenta and fetus may tolerate the effects of up to a 50% reduction in uterine arterial blood flow [ 60 ], this is less likely to be the case in pregnancies complicated by maternal hypertensive disease and/or fetal growth restriction. In an overnight sleep study of 116 participants synchronizing maternal position with fetal heart rate events, maternal position change and especially in the supine position was significantly more likely to be associated with adverse FHR events in women with FGR and/or a hypertensive disorder compared with uncomplicated pregnancies ( p = 0.006) [ 61 ], providing further evidence that the fetus was responding to hypoxia induced by position change.…”

Section: Review Of Physiological Assessments Of Maternal and Fetal Im...mentioning

confidence: 99%

Maternal Cardiovascular Responses to Position Change in Pregnancy

Clark,

Fontinha,

Thompson

et al. 2023

Biology

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The maternal cardiovascular-circulatory system undergoes profound changes almost from the conception of a pregnancy until the postpartum period to support the maternal adaptions required for pregnancy and lactation. Maintenance of cardiovascular homeostasis requires changes in the cardiovascular autonomic responses. Here, we present a longitudinal study of the maternal cardiovascular autonomic responses to pregnancy and maternal position. Over a normal gestation, in the left lateral position there are significant changes in both time and frequency domain parameters reflecting heart rate variability. We show that cardiovascular autonomic responses to physiological stressors (standing and supine positions in late pregnancy) became significantly different with advancing gestation. In the third trimester, 60% of the subjects had an unstable heart rate response on standing, and these subjects had a significantly reduced sample entropy evident in their heart rate variability data. By 6 weeks, postpartum function returned to near the non-pregnant state, but there were consistent differences in high-frequency power when compared to nulligravid cases. Finally, we review complementary evidence, in particular from magnetic resonance imaging, that provides insights into the maternal and fetal impacts of positioning in pregnancy. This demonstrates a clear relationship between supine position and maternal hemodynamic parameters, which relates to compression of the inferior vena cava (p = 0.05). Together, these studies demonstrate new understanding of the physiology of physiological stressors related to position.

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Section: Review Of Physiological Assessments Of Maternal and Fetal Im...mentioning

confidence: 99%

Maternal Cardiovascular Responses to Position Change in Pregnancy

Clark,

Fontinha,

Thompson

et al. 2023

Biology

View full text Add to dashboard Cite

show abstract

“…Moreover, maternal sleep position was associated with changes in fetal behavioral state and FHR variability (Stone et al, 2017). A study of CTG with maternal polysomnography in late pregnancy reported that nocturnal FHR decelerations and prolonged reduction in FHRV were more likely in pregnancies complicated by hypertension and/or FGR, and these changes were associated with maternal sleep position (Wilson et al, 2022). This suggests that an adverse event (e.g.…”

Section: Antenatal Fetal Heart Rate and Heart Rate Variability Markersmentioning

confidence: 99%

Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses

et al. 2022

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Fetal growth restriction (FGR) is a major cause of stillbirth, prematurity and impaired neurodevelopment. Its etiology is multifactorial, but many cases are related to impaired placental development and dysfunction, with reduced nutrient and oxygen supply. The fetus has a remarkable ability to respond to hypoxic challenges and mounts protective adaptations to match growth to reduced nutrient availability. However, with progressive placental dysfunction, chronic hypoxia may progress to a level where fetus can no longer adapt, or there may be superimposed acute hypoxic events. Improving detection and effective monitoring of progression is critical for the management of complicated pregnancies to balance the risk of worsening fetal oxygen deprivation in utero, against the consequences of iatrogenic preterm birth. Current surveillance modalities include frequent fetal Doppler ultrasound, and fetal heart rate monitoring. However, nearly half of FGR cases are not detected in utero, and conventional surveillance does not prevent a high proportion of stillbirths. We review diagnostic challenges and limitations in current screening and monitoring practices and discuss potential ways to better identify FGR, and, critically, to identify the “tipping point” when a chronically hypoxic fetus is at risk of progressive acidosis and stillbirth.

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The influence of maternal sleep disorders on fetal and neonatal outcome

O’Brien

2023

Encyclopedia of Sleep and Circadian Rhythms

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Maternal sleep behaviours preceding fetal heart rate events on cardiotocography

Cited by 6 publications

References 66 publications

Maternal Cardiovascular Responses to Position Change in Pregnancy

Maternal Cardiovascular Responses to Position Change in Pregnancy

Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses

The influence of maternal sleep disorders on fetal and neonatal outcome

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